* Abrupt onset pain
* Decreased vision
* Positive Swinging Flashlight Test !!! [see below]* Swollen optic disk on Fundoscopic exam
- Loss of sharp margins, like papilledema
- Pale disk (optic atrophy) if longstanding
- Work up Multiple Sclerosis (50% of cases)
Swinging Flashlight TestIn a completely dark room, shine a light in the uninvolved eye
- Pupil Constricts.
- Shine it quickly over to the symptomatic side, Pupil Dilates!
- Swing back to the uninvolved, Pupil Constricts.
- Back to the symptomatic eye, Pupil Dilates!
Chart: “Afferent Pupillary Defect” (“APD”) for the side which dilates
See posting Red Eye – 1.